Echocardiographic Doppler estimation of pulmonary artery pressure in critically ill patients with severe hypoxemia

Página do item simplificado
dc.contributor.authorBouhemad, Bélaïd [UNESP]
dc.contributor.authorFerrari, Fabio [UNESP]
dc.contributor.authorLeleu, Kris
dc.contributor.authorArbelot, Charlotte
dc.contributor.authorLu, Qin
dc.contributor.authorRouby, Jean-Jacques
dc.contributor.institutionUniversidade Estadual Paulista (Unesp)
dc.contributor.institutionHospital St.-Jan
dc.contributor.institutionUniversity of Paris-6
dc.contributor.institutionGroupe Hospitalier Pitié-Salpêtrière
dc.date.accessioned2014-05-27T11:22:46Z
dc.date.available2014-05-27T11:22:46Z
dc.date.issued2008-01-01
dc.description.abstractBACKGROUND: In spontaneously breathing cardiac patients, pulmonary artery pressure (PAP) can be accurately estimated from the transthoracic Doppler study of pulmonary artery and tricuspid regurgitation blood flows. In critically ill patients on mechanical ventilation for acute lung injury, the interposition of gas between the probe and the heart renders the transthoracic approach problematic. This study was aimed at determining whether the transesophageal approach could offer an alternative. METHODS: Fifty-one consecutive sedated and ventilated patients with severe hypoxemia (arterial oxygen tension/fraction of inspired oxygen < 300) were prospectively studied. Mean PAP measured from the pulmonary artery catheter was compared with several indices characterizing pulmonary artery blood flow assessed using transesophageal echocardiography: preejection time, acceleration time, ejection duration, preejection time on ejection duration ratio, and acceleration time on ejection duration ratio. In a subgroup of 20 patients, systolic PAP measured from the pulmonary artery catheter immediately before withdrawal was compared with Doppler study of regurgitation tricuspid flow performed immediately after pulmonary artery catheter withdrawal using either the transthoracic or the transesophageal approach. RESULTS: Weak and clinically irrelevant correlations were found between mean PAP and indices of pulmonary artery flow. A statistically significant and clinically relevant correlation was found between systolic PAP and regurgitation tricuspid flow. In 3 patients (14%), pulmonary artery pressure could not be assessed echocardiographically. CONCLUSIONS: In hypoxemic patients on mechanical ventilation, mean PAP cannot be reliably estimated from indices characterizing pulmonary artery blood flow. Systolic PAP can be estimated from regurgitation tricuspid flow using either transthoracic or transesophageal approach. © 2008 American Society of Anesthesiologists, Inc.en
dc.description.affiliationDepartment of Anesthesiology Faculdade de Medicina Universidade Estadual Paulista Julio de Mesquita Filho, Botucatu
dc.description.affiliationHospital St.-Jan, Brugge
dc.description.affiliationDepartment of Anesthesiology Hospital Pitié-Salpêtrière University of Paris-6
dc.description.affiliationRéanimation Chirurgicale Pierre Viars Département d'Anesthésie-Réanimation Groupe Hospitalier Pitié-Salpêtrière, 47 Boulevard de l'Hôpital, 75651 Paris Cédex 13
dc.description.affiliationUnespDepartment of Anesthesiology Faculdade de Medicina Universidade Estadual Paulista Julio de Mesquita Filho, Botucatu
dc.format.extent55-62
dc.identifierhttp://dx.doi.org/10.1097/01.anes.0000296067.02462.34
dc.identifier.citationAnesthesiology, v. 108, n. 1, p. 55-62, 2008.
dc.identifier.doi10.1097/01.anes.0000296067.02462.34
dc.identifier.issn0003-3022
dc.identifier.issn1528-1175
dc.identifier.scopus2-s2.0-37549007599
dc.identifier.urihttp://hdl.handle.net/11449/70241
dc.language.isoeng
dc.relation.ispartofAnesthesiology
dc.relation.ispartofjcr6.523
dc.relation.ispartofsjr2,123
dc.relation.ispartofsjr2,123
dc.rights.accessRightsAcesso restrito
dc.sourceScopus
dc.subjectatracurium
dc.subjectfentanyl
dc.subjectmidazolam
dc.subjectnitric oxide
dc.subjectadult
dc.subjectarterial oxygen tension
dc.subjectartificial ventilation
dc.subjectcontrolled study
dc.subjectcritically ill patient
dc.subjectdisease severity
dc.subjectDoppler echocardiography
dc.subjectfemale
dc.subjectheart ventricle ejection time
dc.subjecthuman
dc.subjecthypoxemia
dc.subjectlung artery pressure
dc.subjectlung blood flow
dc.subjectmajor clinical study
dc.subjectmale
dc.subjectpriority journal
dc.subjectpulmonary artery catheter
dc.subjectsedation
dc.subjectstatistical significance
dc.subjectsystolic blood pressure
dc.subjecttransesophageal echocardiography
dc.subjecttricuspid valve regurgitation
dc.subjectAdult
dc.subjectAged
dc.subjectAnoxia
dc.subjectCritical Illness
dc.subjectEchocardiography, Doppler
dc.subjectFemale
dc.subjectHumans
dc.subjectMale
dc.subjectMiddle Aged
dc.subjectProspective Studies
dc.subjectPulmonary Artery
dc.subjectPulmonary Wedge Pressure
dc.titleEchocardiographic Doppler estimation of pulmonary artery pressure in critically ill patients with severe hypoxemiaen
dc.typeArtigo
dcterms.licensehttp://edmgr.ovid.com/spine/accounts/copyrightTransfer.pdf
unesp.campusUniversidade Estadual Paulista (Unesp), Faculdade de Medicina, Botucatupt

Arquivos

Coleções

Artigos - Anestesiologia - FMB